Arterial hypertension and anticancer drug therapy: pathophysiological relationships and clinical significance

Abstract

Arterial hypertension (AH) is one of the most common cardiovascular complications of anticancer drug therapy. In this review article, we consider the main groups of anticancer drugs that may cause the development of iatrogenic AH, the pathophysiological mechanisms of increased blood pressure, as well as the clinical significance of AH developed during treatment with cytostatics and targeted drugs in the practice of an oncologist and a cardiologist. It was found that AH is frequently associated with the use of angiogenesis inhibitors, as well as alkylating cytostatics, antimetabolites, taxanes, and proteasome inhibitors. In addition, erythropoietins, glucocorticosteroids, and non-steroidal anti-inflammatory drugs used as part of supportive therapy may contribute to an increase in blood pressure. Management of hypertension in cancer patients is an important part of antitumor treatment therapy whose implementation contributes to improving their quality of life. Research into various clinical and pathophysiological aspects of cardiovascular disorders in cancer patients is becoming increasingly relevant, which is indicated by the rapid development of cardio-oncology, a new interdisciplinary field of knowledge aimed at developing practical recommendations for the prevention, diagnosis, and treatment of cardiovascular toxicity caused by anticancer therapy.